Provider Demographics
NPI:1659404648
Name:T & T HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:T & T HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINITRATOR/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:UREVBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-726-9945
Mailing Address - Street 1:3530 FOREST LN STE 265
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7970
Mailing Address - Country:US
Mailing Address - Phone:972-726-9945
Mailing Address - Fax:214-350-4999
Practice Address - Street 1:3530 FOREST LN STE 265
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7970
Practice Address - Country:US
Practice Address - Phone:972-726-9945
Practice Address - Fax:214-350-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008910251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH245HOtherBLUE CROSS BLUE SHIELD
TXHH245HOtherBLUE CROSS BLUE SHIELD